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Educational progress, behaviour, and motor skills at 10 years in early treated congenital hypothyroidism
W F Simons1, P W Fuggle, D B Grant
1Institute of Child Health, London.
Insights
Children with severe congenital hypothyroidism (CH) show mild impairments in education and motor skills by age 10. Behavioural issues, including attention difficulties, are also common, even in milder CH cases.
Area of Science:
- Pediatric Endocrinology
- Developmental Pediatrics
- Neurodevelopmental Disorders
Background:
- Congenital hypothyroidism (CH) is a condition present at birth affecting thyroid hormone production.
- Neonatal screening allows for early identification and treatment of CH.
- Long-term neurodevelopmental outcomes in treated CH require continued investigation.
Purpose of the Study:
- To evaluate educational attainments, behavioral patterns, and motor skills at age 10 in children diagnosed with CH via neonatal screening.
- To compare outcomes between children with severe CH (pretreatment thyroxine [T4] ≤ 40 nmol/l) and less severe CH (T4 > 40 nmol/l), and with controls.
Main Methods:
- A cohort of 59 children with CH (31 severe, 28 less severe) and 59 matched controls were assessed at age 10.
- Standardized assessments included reading ability (Neale analysis), mathematics (Child Health and Education Study test), behavior (Rutter questionnaires), and motor proficiency (Oseretsky test).
Main Results:
- Children with severe CH (Group I) demonstrated significantly poorer educational attainments (mathematics), motor skills, and behavior compared to less severe CH (Group II) and controls.
- While reading differences were not significant, mathematics and total motor skills deficits were statistically significant (p < 0.01).
- Behavioral issues, particularly attentional difficulties, were significantly more prevalent in Group I and also observed in Group II children.
Conclusions:
- Severe congenital hypothyroidism is linked to mild impairments in educational and motor development by age 10.
- Behavioral problems are a notable concern in children with CH, extending even to those with less severe forms of the condition.
Aim:
To assess educational attainments, behaviour, and motor skills at 10 years of age in a group of children with congenital hypothyroidism identified by neonatal screening.
Subjects:
59 children with congenital hypothyroidism born in 1978-81, 31 cases with pretreatment thyroxine (T4) values of 40 nmol/l or below (group I) and 28 less severe cases with T4 values over 40 nmol/l (group II), together with 59 classroom control children matched for age, sex, social class, and main language spoken at home.
Methods:
The Neale analysis of reading ability; the child health and education study written test of mathematics; Rutter behaviour questionnaires for parents and teachers; the Oseretsky test of motor proficiency (short form).
Results:
On all measures the congenital hypothyroidism children in group I had less satisfactory scores for educational attainments, behaviour, and motor skills than those in group II and controls. For reading the differences were small and did not reach statistical significance, but the deficits in mathematics and total motor skills were statistically significant (p < 0.01). There were more striking and statistically significant differences in behaviour scores, particularly with respect to attentional difficulties. Although less striking, these were also apparent in the group II children with mild hypothyroidism.
Conclusions:
At the age of 10 years severe congenital hypothyroidism is associated with some mild impairment in educational and motor attainments. Behaviour problems are also common, even in some children with less severe congenital hypothyroidism.
